Motivational Interviewing
Abstain from lying, from divisve speech, from abusive speech, and from idle chatter: This is called right speech
Motivational Interviewing is a way of conversing about important issues where there is disagreement. William Miller and Stephen Rollnick, who were working with addiction patients, developed the technique to address the question of why people don’t change. If you learn the technique, and it begins to feel natural to use, you will be surprised about how it can engage someone and encourage them to examine the way they look at things.
“Right Speech” in the opening quote, are practices that your mother probably tried to teach you. It is as true today as it was 2000 years ago. They are also essential for motivational interviewing. Don’t lie. Don’t speak in a way that alienates people. Don’t be verbally abusive. Don’t make foolish and irrelevant talk.
Principles
Beyond right speech, there are four main principles of motivational interviewing (Table I: Four Principles of MI). Although the steps seem clear, it requires empathy to know the right thing to say and when to avoid setting off resistance in the other person. In terms of change, every person lies on a continuum from being unaware, to thinking it might be a good idea to change, to planning, to reviewing how things went. If things did not go well, you need to plan what to do differently. Timing means your comments are helpful for the particular part of the continuum the other person is at. It is different talking to a person who sees no problem than talking to someone who has just slipped backward. (Table 2: Six Stages of Change)
In any stage, it is important to avoid arguing. If you feel there is resistance, like having a person say “Yes, but…”, look at it as a sign to respond differently. As long as your intention is right, people are forgiving. Just apologize for what you said and tell them what you meant to say.
Change Talk
Change talk is mainly asking questions in a way that makes a person commit to change and to make plans without telling them what to do. What makes this hard is the natural tendency to resist change. In general, don’t ask closed-ended questions like “Don’t you want to change?” They will just say no, and the discussion stops. It is always better to use open-ended questions. People are more open if they try to explain their answers.
For example, how would you respond to a person who is spouting off about “those people…” of whom you are one. The best response might just be to ask, “Those people?” and listen. The person might feel they are victims of reverse discrimination, which is your chance to talk about the shared experience of exclusion and discrimination. You might ask, “How have you tried to cope with unfairness or intolerance against you?” and talk briefly about a similar experience you faced.
From this beginning, helpful tips about change-talk are listed in (Table 3: Change Talk). To change, you usually need to take stock, think of the pros and cons for change, plan, and then talk about how things went.
Tips
General Conduct Tips on general conduct are listed in (Table 4: General Conduct). Basically, don’t do all the talking and show you’re listening by making reflective statements (i.e. use the “because” or “when” formula, like you were angry “because” you were left out, or “when” that happened).
“Traps” Tips on avoiding typical pitfalls or “traps” are listed in (Table 5: Typical Pitfalls). These are things like getting pulled into an argument, labeling, blaming, taking sides, or deciding on what is best without the person’s agreement.
Common Errors Typical errors people make are listed in (Table 6: Typical Errors). They are considered errors when they stop open communication. These errors include ordering, lecturing, persuading with logic, threatening, and not being aware of how hostile or insulting you sound.
Signs of Resistance Signs that the other person is resisting are listed in (Table 7: Signs of Resistance). Resistance is the refusal to accept or comply. They generally get angry, argue, or ignore you.
Conclusion:
Motivational Interviewing is not considered psychotherapy. Instead, look at it as common-sense guidelines on how to have difficult conversations without making the other person defensive. A future blog will give a self-rating tool for Motivational Interviewing. When you begin to change your style of conversing with people about difficult topics, like talks about race, you need to have a way to know if you are doing it right. The beginner’s self-rating tool is a modified rating scale that came from a National Institute of Drug Abuse (NIDA) Self-Assessment form for training alcohol abuse counselors in motivational interviewing. The full form will also be attached.
